{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T19:59:06Z","timestamp":1774468746436,"version":"3.50.1"},"reference-count":77,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:00:00Z","timestamp":1672272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006545","name":"National Institute On Minority Health and Health Disparities of the National Institutes of Health","doi-asserted-by":"publisher","award":["U54MD012393"],"award-info":[{"award-number":["U54MD012393"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Compared with other racial\/ethnic groups in the United States, American Indians\/Alaska Natives have the highest rates of acute Hepatitis C Virus (HCV) infection, the highest HCV-related mortality, and one of the fastest climbing rates of drug overdose deaths involving stimulants. In this pilot study, a life history calendar was administered to Indigenous people who use injection drugs (IPWIDs) to understand sequences of polysubstance use across the lifespan. 40 IPWIDs completed a questionnaire and life history calendar. Social sequence analysis was used to examine patterns in sequential phenomena among substances reported over years of the lifespan. Most participants (55%) began injecting substances before the age of 21, 62.5% shared syringes with others, and 45% had ever been diagnosed with HCV. An appreciably large increase in the use of stimulants occurred between the year prior to and following injection initiation (33% to 82%). A three-cluster solution distinguished younger IPWIDs transitioning into polysubstance use involving stimulants and\/or narcotic analgesics from adults using narcotic analgesics with stimulants over longer periods of time, and adults most focused on stimulant use over time. Findings from this pilot study contribute to an understanding of how methamphetamine injection plays a role in the HCV epidemic among IPWIDs.<\/jats:p>","DOI":"10.3390\/ijerph20010543","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T02:56:50Z","timestamp":1672282610000},"page":"543","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A Pilot Study of Polysubstance Use Sequences across the Lifespan among Assiniboine and Sioux People Who Use Injection Drugs"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7761-572X","authenticated-orcid":false,"given":"Michael","family":"Anastario","sequence":"first","affiliation":[{"name":"Robert Stempel College of Public Health & Social Work, Research Center in Minority Institutions, Florida International University, Miami, FL 33199, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Firemoon","sequence":"additional","affiliation":[{"name":"Fort Peck Community College, Poplar, MT 59255, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health & Social Work, Research Center in Minority Institutions, Florida International University, Miami, FL 33199, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carrie","family":"Wade","sequence":"additional","affiliation":[{"name":"Independent Researcher, Belize City, Belize"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Prokosch","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical School, Minneapolis, MN 55455, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5738-5496","authenticated-orcid":false,"given":"Elizabeth","family":"Rink","sequence":"additional","affiliation":[{"name":"Department of Health and Human Development, Montana State University, Bozeman, MT 59717, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9222-085X","authenticated-orcid":false,"given":"Eric","family":"Wagner","sequence":"additional","affiliation":[{"name":"Robert Stempel College of Public Health & Social Work, Research Center in Minority Institutions, Florida International University, Miami, FL 33199, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,29]]},"reference":[{"key":"ref_1","unstructured":"US Centers for Disease Control and Prevention (2022, May 19). 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